学龄期儿童消化性溃疡并发出血的危险因素分析  

Analysis of Risk Factors for Hemorrhage Occurrence in School⁃age Children with Peptic Ulcer

作　　者：王瑞 阮倩倩 WANG Rui;RUAN Qianqian(Department of Pediatric Nephrology and Endocrinology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院儿童肾病内分泌科,河南南阳473000

出　　处：《中国烧伤创疡杂志》2024年第6期482-486,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的探讨分析学龄期儿童消化性溃疡并发出血的相关危险因素。方法选取2020年3月至2023年3月南阳市中心医院收治的213例学龄期消化性溃疡患儿作为研究对象,收集患儿性别、有无家族史、年龄、溃疡类型、溃疡病程、是否喜好酸辣、有无幽门螺杆菌(Hp)感染、有无心理障碍、有无可加重消化性溃疡病情药物(抗生素、激素、非甾体类抗炎药等)应用史、临床症状(有无呕血、柏油样便或血便等)、是否并发出血等相关资料,并根据患儿并发出血情况将其分为出血组和非出血组,Logistic回归分析并发出血的相关危险因素。结果213例消化性溃疡患儿并发出血60例(28.17%),临床表现为呕血25例(41.67%)、柏油样便35例(58.33%)、嗳气反酸22例(36.67%)、腹痛不适20例(33.33%)、恶心呕吐21例(35.00%),设为出血组;其余153例(71.83%)未并发出血,设为非出血组。单因素分析结果显示,出血组中性别为男性、有家族史、年龄为11~13岁、溃疡病程≥1年、喜好酸辣、有Hp感染、有心理障碍、有可加重消化性溃疡病情药物应用史的患儿明显多于非出血组(χ^(2)=7.502、50.233、8.851、6.927、7.148、8.759、4.719、7.392,P=0.006、P<0.001、P=0.003、P=0.008、P=0.008、P=0.003、P=0.030、P=0.007)。Logistic回归分析结果显示,性别为男性、有家族史、年龄为11~13岁、溃疡病程≥1年、喜好酸辣、有Hp感染、有心理障碍、有可加重消化性溃疡病情药物应用史是学龄期儿童消化性溃疡并发出血的独立危险因素(95%CI为1.329~4.516、1.318~11.888、1.848~32.710、1.188~6.046、1.133~5.763、1.937~7.914、1.182~11.257、1.155~1.771,P=0.004、0.014、0.005、0.017、0.023、0.001、0.024、0.001)。结论学龄期儿童消化性溃疡并发出血以呕血和柏油样便为主要临床表现,且其发生与性别、有无家族史、年龄、溃疡病程、是否喜好酸辣、有无Hp感染、有无心理障碍、有无可加重消�Objective To analyze the risk factors for hemorrhage occurrence in school⁃age children with peptic ulcer.Methods 213 school⁃age children patients with peptic ulcer admitted to Nanyang Central Hospital from March 2020 to March 2023 were selected as research subjects,and their data were collected including sex,family history,age,type of ulcer,duration of ulcer,hot and sour taste preference,Helicobacter pylori(Hp)infection,psychological disorders,history of application of medications that may aggravate peptic ulcer(antibiotics,hormones,nonsteroidal anti⁃inflammatory drugs,etc.),clinical symptoms(hematemesis,tarry stool or bloody stool,etc.),and complication of hemorrhage.The children patients were divided into hemorrhage group and non⁃hemorrhage group based on the occurrence of hemorrhage.Logistic regression analysis was conducted to analyze the risk factors for the complication of hemorrhage.Results Among the 213 children patients with peptic ulcer,60 patients(28.17%)were complicated with hemorrhage,being set up as the hemorrhage group and with clinical manifestations of hematemesis in 25 cases(41.67%),tarry stool in 35 cases(58.33%),belching and acid regurgitation in 22 cases(36.67%),abdominal pain and discomfort in 20 cases(33.33%),and nausea and vomiting in 21 cases(35.00%);and the other 153 cases(71.83%)without the occurrence of hemorrhage were set as non⁃hemorrhage group.The results of univariate analysis showed that the proportions of children patients with male gender,family history,age of 11-13 years,ulcer duration≥1 year,hot and sour taste preference,Hp infection,psychological disorders,and history of application of medications that may aggravate peptic ulcer were significantly higher in the hemorrhage group compared with the non⁃hemorrhage group(χ^(2)=7.502,50.233,8.851,6.927,7.148,8.759,4.719 and 7.392,P=0.006,P<0.001,P=0.003,P=0.008,P=0.008,P=0.003,P=0.030,P=0.007).Multivariate Logistic regression analysis showed that,gender of male,family history,age of 11-13 years,ulcer duration≥1 yea

关 键 词：学龄期 儿童 消化性溃疡 消化道出血 危险因素 

分 类 号：R725.7[医药卫生—儿科]